Too Much of a Good Thing

Acetaminophen is the generic name for the commonly used over-the-counter (OTC) product Tylenol®. Since acetaminophen is most often used to reduce pain and fever, it is found in many combination OTC and prescription medications. Many consumers have the misconception that acetaminophen is extremely safe because it is so easily available and unlike ibuprofen, aspirin, or naproxen, it does not cause stomach pain or bleeding.

Acetaminophen can be most dangerous when the daily recommended total dose of 4 grams is exceeded. An overdose of acetaminophen can lead to liver damage. Patients with liver disease should probably receive less than 4 grams of acetaminophen per day, but should consult their physician for the recommended daily maximum dose.

A study in 2005 showed that acetaminophen poisoning accounted for 42 percent of acute liver failure cases. Many of these cases were caused by unintentional acetaminophen overdose. The FDA held a meeting in June 2009 to help decrease the number of consumers who experience liver toxicity through acetaminophen use. A public education campaign has been started to educate consumers.

Consumers can do their part by reading all of the ingredients in combination products. On OTC medications, check the “Drug Facts” label under the “Active Ingredients” section. On prescription combination products, it can be listed as acetaminophen or APAP, a well known abbreviation for acetaminophen.

Common prescription medications that contain acetaminophen:

Acetaminophen and Hydrocodone (Vicodin®, Lortab®, Norco®)
Acetaminophen and Oxycodone (Percocet®, Roxicet®, Endocet®)
Acetaminophen and Propoxyphene (Darvocet-N®)
Acetaminophen and Tramadol (Ultracet®)
Acetaminophen and Isometheptene and Dichloralphenazone (Midrin®)
Acetaminophen and Butalbital and Caffeine (Fioricet®)
Acetaminophen and Codeine (Tylenol #3®, Tylenol #4®, Tylenol Elixir with Codeine)

Common OTC medications that contain acetaminophen:

Acetaminophen and Diphenhydramine (Tylenol PM®, Excedrin PM®, Tylenol Severe Allergy®)
Acetaminophen and Aspirin and Caffeine (Excedrin® Extra Strength, Excedrin® Migraine)
Acetaminophen and Pamabrom (Midol®)
Acetaminophen and Phenylephrine (Alka-Seltzer Plus® Sinus Formula, Sudafed PE® Sinus Headache, Vicks® DayQuil® Sinus, Excedrin® Sinus Headache)
Acetaminophen and Dextromethorphan and Doxyalamine (Vicks® NyQuil® Cold and Flu Multi-Symptom)
Acetaminophen with Chlorpheniramine (Coricidin HBP® Cold and Flu)

Make sure you are checking your medication lists twice so that you aren't doubling up on your medications. And as always, speak to your family doctor regarding any medication changes.


Alisia Baker, Pharm.D.

Tips for Halloween Safety

Just a little over two weeks to go before the big night of “trick or treat” commences. Personally, I have bought two bags prototype candy. Of course the treats must be tasted and tested before I hand it out to my neighborhood goblins. I am a responsible neighbor after all. I have also checked and made sure my front porch and driveway are clearly lit and there are no tripping hazards (such as garden hoses) for the galloping ghosts. I have a plan for my alarmingly energetic Jack Russell that includes being secured in the house to avoid any potential escapes she might attempt with the overactive ringing of the doorbell.

Now that the basic arrangements are made, I have started talking with my teenage daughter. It is an ongoing dialogue about being aware of her surroundings while driving. Certainly this conversation is frequented often, but as Halloween nears it is even more important. Remember how excited these little ghouls get questing for candy—they run right out into the streets and don’t even think to look both ways. Many costumes are dark and scary, and difficult to see from a driver’s point of view. Extra caution is the answer for everyone, especially the teen drivers.

Remind the witches and warlocks to be wary of parked cars. Crossing the street with an adult or in a group is always a safer approach. And speaking of groups, trick or treating in packs is a sure way to have a more enjoyable evening. Remind the kids to get their goodies from the front door and never go inside the house. Lastly, before they gobble those goodies, they should be inspected by an adult, making sure the candy is securely wrapped and not tampered with. It’s often tough being a parent, but during this time of year, how sweet it is.

Mary Ann Contreras, RN

Injury Prevention Coordinator

Breakfast tips: feed your kids and YOU

Alarm rings, kids won’t get out of bed, you forgot to iron your clothes for work, dog is barking…eat breakfast? Yeah right!

This is a typical morning for many families in the United States. They run out the door without fueling for their day. So what is the problem? A nutrient-rich breakfast is key to helping people feel energized, stay focused and feel less hungry later in the day. Research shows that people who eat a complete breakfast typically manage their weight better and children think better, problem solve more efficiently and stay focused on their school work.

I would like to encourage all MOMS to feed themselves while feeding their kids! So many moms make breakfast and pack lunches for their kids and husband, but forget to fuel their own body. As women age, their metabolism slows down and skipping meals makes it worse! So no, the thought that “less is better” is not always the case, especially not with nutrition. In order to get your metabolism up and running, you have to eat breakfast, more than a yogurt or piece of fruit! Think of it like this…eat breakfast like a king, lunch like a prince and dinner like a pauper!

5 Quick Breakfasts for YOU and your KIDS:

2 slices 100% whole wheat toast each with 1 Tbs. natural peanut butter and top with slices banana
1 scrambled egg, 2 oz turkey sausage, 1 whole 100% wheat mini bagel with 2 Tbs. 100% fruit jelly and 8 oz low-fat milk
1 cup cooked oatmeal topped with ½ cup fresh blueberries and 2 Tbs. chopped pecans, 8 oz low-fat milk
Yogurt Parfait: 6 oz low-fat Greek yogurt, 1 Tbs. honey, ¾ cup whole grain cereal and 2 Tbs. chopped nuts (or flaxseed)
Non-traditional breakfast: 1 – 100% whole wheat tortilla rolled with 2 oz turkey and 1 slice 2% cheese in addition to a pre-made yogurt smoothie

Breakfast Check List:
Make sure your breakfast consists of complex carbohydrates (ex: whole grain cereal, wheat bread, fruit, low-fat milk), protein (ex: eggs/egg whites, lean meat, nuts), and some healthy fat (peanut butter, nuts, light cream cheese)

Look for whole wheat bread and grain products instead of white/refined products
Choose low-fat (skim, 1% or 2%) milk and dairy products
Limit your intake of fried foods, grease, and extra gravies & sauces
Aim to get fruit into your breakfast either as a juice or as a whole fruit

What is your go-to breakfast for yourself and your kids?

Amy Goodson, MS, RD, CSSD, LD

Registered Dietitian

For more tips and stories about moms in the Dallas/Fort Worth area, visit www.texashealthmoms.blogspot.com.

The Road Less Traveled

“Two roads diverged in a yellow wood,
And sorry I could not travel both…” -Robert Frost

Life is unpredictable. Just ask anyone in the medical field. As we travel down the road of life we have to make decisions as to which way to go when we come to a crossroad. But what if you couldn’t tell us that decision? Does your family know what you want? What if you could no longer care for yourself? What if you could no longer feed yourself? Sooner or later this is a crossroad we all must face. In many cases, we as medical professionals can’t always provide our patients and families with immediately clear answers regarding a prognosis on a disease or injury, so knowing which direction your loved one would want to go helps ease the decision-making process during difficult times.

As healthcare providers we often have to help families through these troubled times of “guessing” and “assuming” what a loved one would want because they simply had never had this difficult dialogue. You are never too young or to healthy to have this vital conversation. Questions to consider and discuss with your family could include (but are not limited to):

1) Who you want to make health care decisions for you when you can no longer make them yourself? We should all choose someone to make difficult choices for us. It is vital that this person be able to agree to respect your wishes.

2) What kind of medical treatment do you want or not want? Life is precious. We all want to be treated with dignity, especially during difficult times. Dignity also means that your loved ones know your wishes and respect them when you are unable to communicate them yourself.

3) How comfortable do you wish to be if you have a chronic or life limiting disease? Most people wish to spell out for physicians and care givers that they want to be kept free from pain, nausea, and shortness of breath. Clearly identifying what you want treated and don’t want treated will make these choices that much easier.

4) How you want people to treat you? Do you want to be surrounded by your loved ones as the hours of your life draw to an end? Do you enjoy music and want your family to play music for you? Do you want to have pictures for special memories and share stories of the past? Do you want spiritual support from a church or chaplain? What customs and rituals would you like to have honored?

5) What do you want your loved ones to know as they care for you? It is also important to discuss feelings with loved ones during this time so that the ones you care about know how you feel about them in case you are unable to communicate those feelings at a later date. Leaving a letter with your last will and testament is a very moving way to let your loved ones know how important they were to you if you are unable to voice this in the end.

As an individual it is your right to make these decisions for yourself. Most of us have considered this at some point in our lives, but have we communicated it to those who care about us? If you come to a fork in the road about making life decisions do you and your family know which way to go?

Kenneth Ellis, RN; Ashley Hodges, RN; Jennifer Nelson, RN

Palliative Care

Healthy Harvest Bites…

A healthy cookie twist!

More than just a decorative Halloween candleholder or a pie filling to be eaten only once a year, pumpkin is one of the most nutritional foods available year round. Rich in antioxidants, vitamins, minerals, and low in fat, both the flesh and seeds of the pumpkin provide many health-boosting nutrients. Check out some of the nutrients in pumpkin:

Alpha-carotene
Beta-carotene
Fiber
Vitamins C and E
Potassium
Magnesium
Pantothenic acid

Pumpkin is an excellent source of fiber; one-half cup serving contains 5 grams of fiber. Fiber helps reduce bad cholesterol levels, protect the body against heart disease, control blood sugar levels, promote healthy digestion, and plays a role in weight loss. In addition, alpha-carotene and beta-carotene are potent antioxidants found in pumpkin and are pro-vitamin A carotenoids which converts to vitamin A in the body. Vitamin A promotes healthy vision and ensures proper immune function. Not to mention, the Vitamin C in pumpkin also boosts immunity! Pumpkin also contains Vitamin E which promotes healthy skin by protecting the body from sun damage. So, stock up on pumpkin this fall and start by making the Pumpkin Protein Cookies!

“Pumpkin Protein Cookies” Recipe

3/4 cup SPLENDA® Granular
1 cup rolled oats
1 cup whole wheat flour
1/2 cup soy flour
1 3/4 teaspoons baking soda
1/2 teaspoon baking powder
1/2 teaspoon salt
2 teaspoons ground cinnamon
1 teaspoon ground nutmeg
1/2 cup pumpkin puree
1 tablespoon canola oil
2 teaspoons water
2 egg whites
1 teaspoon molasses
1 tablespoon flax seeds (optional)

Directions:
Preheat oven to 350 degrees F (175 degrees C). In a large bowl, whisk together Splenda®, oats, wheat flour, soy flour, baking soda, baking powder, salt, cinnamon, and nutmeg. Stir in pumpkin, canola oil, water, egg whites, and molasses. Stir in flax seeds, if desired. Roll into 14 large balls, and flatten on a baking sheet. Bake for 5 minutes in preheated oven. Cookies will turn out dry if overbaked.

Nutrition Facts per Serving:
Calories: 89, Carbohydrate: 15 gm, Fiber: 2.5 gm, Protein: 4 gm, Fat: 2 gm, Cholesterol: 0 mg

Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian
Ben Hogan Sports Medicine
Executive Health Program

If you have a question for the dietitian,visit www.texashealth.org/askamy

Halloween: Part One

What are you going to be for Halloween? My children used to pull out the box of costumes to see what would work for that year. There was always lots of princess attire as well as witches and a few odds and ends that could be transformed into aliens, ninja turtles and pirates. This year’s top costumes revolve around pop-culture icons such as Lady Gaga and movies like Avatar and Toy Story 3.

As you prepare for the big night out, remember to keep those costumes safe. Not too long as to cause a tripping hazard. Be careful with candles inside of pumpkins. Masks and head gear should not obstruct the gremlin’s vision. And speaking of vision, remember to take a flashlight, especially when crossing streets. Until next week, happy costume hunting!

Mary Ann Contreras, RN

Injury Prevention

Mother and Babies Need Skin to Skin

Recent studies support what mother’s have known instinctively for generations. Mothers and babies belong together from the moment of birth. Skin to skin contact between mothers and babies immediately after delivery has many benefits for the new family.

Skin to skin contact involves drying the infant and placing him/her immediately from the womb to the bare skin of the mother’s abdomen, then placing a warmed blanket over the two of them. According to mammalian neuroscience, the intimate stimuli inherent in this kind of contact evokes neuro-behaviors ensuring fulfillment of basic biological needs and may program future behavior. Thirty studies involving 1925 participants found the following positive effects to keeping mothers and babies skin to skin immediately after birth.

Benefits to Baby:

· Stabilization of the baby’s heart rate with a decrease in bradycardia episodes
· Improved regular breathing patterns and a decrease in apnea episodes
· Improved oxygen saturation rates
· Improved temperature regulation
· Increased restful and deeper sleep
· Increase in weight gain
· Shorter hospital stays

Benefits to Parents:

· Improved bonding supports closeness to baby
· Increase in breast milk supply
· More successful breastfeeding episodes
· Increased confidence in the ability to care for the baby

Gloria Glidewell, CNM, MS

Nutrition Support in Critical Care

When patients cannot help themselves in any capacity, there are professionals that step in and take the necessary steps to ensure that they receive the type of care that will sustain and nourish them back to the point where they can do it on their own. In the clinical nutrition field, professionals like Debbie Foster do just that.
Debbie’s career as a licensed and certified nutrition support dietitian began with Texas Health HEB and Texas Health Fort Worth.
“When I was a student working part-time, day after day I observed a culture of compassion, care and professionalism at both hospitals. It had a strong impact on me and I knew this is where I wanted to be.”
When asked about her daily motivators, she said “My satisfaction comes from having a direct impact on improving my patient’s overall outcomes”.
“I enjoy being able to use nutrition as part of the healing process that helps to get patients back to a productive and healthy life.”
Family members find it comforting to know that when their loved ones may be unable to eat on their own, there is someone ensuring that they are receiving the best source of nutrition.
Healthcare and science have always been a passion for Debbie. The profession allows her to use her passion to help others. She enjoys being part of a multidisciplinary healthcare team dedicated to the improving the health of the community mind, body and spirit.

Debbie Foster

Registered Dietitian

Get Your Metabolism Fire Burning!

Alarm rings, kids won’t get out of bed, you forgot to iron your clothes for work, dog is barking…eat breakfast? Ya right! This is a typical morning for many families in the United States. They run out the door without fueling for their day. So what is the problem? A nutrient-rich breakfast is key to helping people feel energized, stay focused and feel less hungry later in the day. Research shows that people who eat a complete breakfast typically manage their weight better and children think better, problem solve more efficiently and stay focused on their school work.

September is National Breakfast Month and we would like to encourage you to get your metabolism burning with breakfast! Think of your metabolism like a fire…in order to get a fire going you have to use a sufficient amount of wood. Same with your metabolism fire…you need to fuel your body with a sufficient amount of nutrition to get the fire burning. Try to wake up five to ten minutes earlier and make time for breakfast whether you are a mom, dad, single adult or teenager…everyone needs breakfast!!! Here are some examples to get you started…

5 Quick Breakfasts for YOU and your KIDS:

2 slices 100% whole wheat toast each with 1 Tbs. natural peanut butter and top with slices banana
1 scrambled egg, 2 oz turkey sausage, 1 whole 100% wheat mini bagel with 2 Tbs. 100% fruit jelly and 8 oz low-fat milk
1 cup cooked oatmeal topped with ½ cup fresh blueberries and 2 Tbs. chopped pecans, 8 oz low-fat milk
Yogurt Parfait: 6 oz low-fat Greek yogurt, 1 Tbs. honey, ¾ cup whole grain cereal and 2 Tbs. chopped nuts (or flaxseed)
Non-traditional breakfast: 1 – 100% whole wheat tortilla rolled with 2 oz turkey and 1 slice 2% cheese in addition to a pre-made yogurt smoothie

Breakfast Check List:

Make sure your breakfast consists of complex carbohydrates (ex: whole grain cereal, wheat bread, fruit, low-fat milk), protein (ex: eggs/egg whites, lean meat, nuts), and some healthy fat (peanut butter, nuts, light cream cheese)
Look for whole wheat bread and grain products
Choose low-fat (skim, 1% or 2%) milk and dairy products
Limit your intake of fried foods, grease, and extra gravies & sauces
Aim to get fruit into your breakfast either as a juice or as a whole fruit

Amy Goodson, MS, RD, CSSD, LD

Registered Dietitian

If you have a question for the dietitian, visit www.texashealth.org/askamy

The journey has speed bumps…

Well I have been pretty busy over the last couple weeks. My stress level reached an all time high, but finally settled down a little bit last Friday. I changed careers with little to no notice, went out of town a couple times, posed for a photo shoot, got sick and scared myself senseless, and the list just keeps on going.

So I am a big believer now that stress and bariatric surgery do not mix well. I went to the Bariatrics support group a couple weeks ago and was not feeling all that well. I talked with our dietician Jaime Bass about what was going on and she suggested that I give Dr. Lorimer a call the next morning. Little did I know that before I could make it home that all hell would break loose and I would start panicking enough to make me call the doctor. For those who don’t know me very well, I avoid calling doctors at all cost and very rarely will even take aspirin if I can help it.

On the way home, I started feeling worse than when I was at the hospital so I pulled over on the side of the road to give myself a moment. Next thing I know I was vomiting uncontrollably on I-30 and feeling like I was about to die right there next to my truck. After calling my dad (who is also a bariatric patient) to get his thoughts, I got back in the car thinking the worst was over. This was probably a very bad idea, as it got worse the longer I drove. I got home and called Dr. Lorimer and talked things through. I took it easy all weekend eating mostly soup until I got a chance to go see Dr. Lorimer this last week. Last Wednesday, I got in to see the good doc and we talked everything through further and then I went over to see a gastro doc. The appointment was short and sweet and I am now scheduled for Friday September 16 to have another procedure to get to the bottom of some of these recent issues. I am a little nervous about it just because I am a little worried about knowing what is really going on inside. I will admit though that I am excited about potentially being able to expand my diet further than soup menu!! I will update everyone after I find out more on Friday.

Another exciting thing I did last week was I became a model (Fashion Week, here I come). Only temporarily, but I drove to downtown Dallas to pose for photos for an upcoming article the Dallas Morning News and Fort Worth Star Telegram are doing in a special section for Texas Health Resources. There are going to be some amazing articles in the section. I brought in a bunch of my old clothes from before surgery and diligently stood between them, laid on top of them, and manipulated myself through them for about an hour. It really made me take a look back at how big I had really gorwn just over a year ago. One of the biggest eye openers during this experience was holding a photo of my son and I this past spring from our t-ball team. I don’t think I really ever realized how big I looked until last Friday. I am proud to say that I can now see a huge difference from before.

-Casey Armstrong

Bariatrics Patient

Giving the Gift of Life

My name is Claudia and three years ago I was diagnosed with Good Pastures Syndrome, an autoimmune disease that attacks the kidney and lungs. As I was told by one of the doctors, it was simply my “bad luck” that I contracted this disease because the odds of getting it are very rare. The disease took both of my kidneys, but thanks to the wonderful team of doctors at Texas Health Fort Worth, its progression was stopped before any further damage could be done.
As a single mom it impacted not just me, but my son as well because I am the only family he has. Through everything he was so scared that he would lose me. But I knew the Lord would get us through this. I do often think and say a special prayer for my donor and their family. I sent them a thank you letter for being so thoughtful. While my family and I rejoiced over receiving the gift of life, they were grieving the loss of a loved one. I only wish they knew how much I value them and am so grateful for everything because if it wasn't for them, my son wouldn't have his Mommy.
On June 30, I will celebrate the one-year anniversary of my transplant. This whole experience has changed my life completely. It gave me back my life; my independence and most important, more time to cherish with those I love the most, my family and friends.
I have always lived a good, healthy Christian life, but now I go to the extreme! I exercise regularly and pay more attention to my diet. And most importantly, I enjoy every day. If you are a donor or the family of a donor THANK YOU and if you are not, please consider becoming one. This decision can many lives!

Fall into Nutrition with Winter Squash

Shop seasonal this fall! Winter squash is available from August through March; however, they are at their best from October to November when they are in season. Winter squash, members of the Cucurbitaceae family and relatives of both the melon and the cucumber, come in many different varieties. While each type varies in shape, color, size and flavor, they all share some common characteristics. Their shells are hard and difficult to pierce, enabling them to have long storage periods between one and six months. Their flesh is mildly sweet in flavor and finely grained in texture. Additionally, all have seed-containing hollow inner cavities.

Winter squash are also rich in a variety of vitamins and minerals. It is a great source of Vitamin A in the form of beta-carotene which has powerful antioxidant and anti-inflammatory properties. Beta-carotene is able to prevent the oxidation of cholesterol in the body. Since oxidized cholesterol is the type that builds up in blood vessel walls and contributes to the risk of heart attack and stroke, getting extra beta-carotene in the diet may help to prevent the progression of atherosclerosis. Winter squash is also an excellent source of Vitamin C, potassium, dietary fiber and manganese. Potassium may help lower blood pressure and Vitamin C is known for its ability to strengthen the immune system. In addition, dietary fiber is significant in helping lower bad (LDL) and total cholesterol.

Get to know your 5 winter squashes:
Butternut Squash: Shaped like a large pear, this squash has cream-colored skin, deep orange-colored flesh and a sweet flavor
Acorn Squash: With harvest green skin speckled with orange patches and pale yellow-orange flesh, this squash has a unique flavor that is a combination of sweet, nutty and peppery
Hubbard Squash: A larger-sized squash that can be dark green, grey-blue or orange-red in color, the Hubbard's flavor is less sweet than many other varieties
Turban Squash: Green in color and either speckled or striped, this winter squash has an orange-yellow flesh whose taste is reminiscent of hazelnuts
Pumpkins: The pumpkin with the most flesh and sweetest taste is the small sized one known as sugar or pie pumpkin, the latter referring to its most notable culinary usage

Amy Goodson, MS, RD, CSSD, LD

EHP Registered Dietitian
Ben Hogan Sports Medicine Dietitian

If you have a question for the dietitian, visit www.texashealth.org/askamy

The Role of Palliative Care to Improve Quality of Life

Why do only cancer patients get Palliative care? This is often the question posed by many patients and family members with other terminal illnesses such as Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), or neurological diseases with difficult to manage symptoms. The fact is, end-stage COPD typically results in debilitating dyspnea, poor quality of life, and increased morbidity and mortality. Patients frequently require several hospital admissions a year for relief of acute exacerbation of COPD symptoms. This negatively impacts patient’s quality of life as they enter the final chapters of their life. Additionally, COPD sufferers become increasingly homebound with limited mobility and ever reliant upon family members to assist with everyday care and ADLs.

Palliative care has been proven to improve perceptions of quality of life and decrease health care costs to patients with terminal cancer. The same positive influence can be utilized in those with end stage COPD, CHF, or any terminal illness. Unfortunately, patients suffering from these conditions typically are not as prepared to face end-of-life decisions, discuss dying, or prepare for death with family members in comparison to those same patients entering the end stages of cancer. This has as much to do with the unwillingness of patient’s to engage in end-of-life care planning, as it does the uncertainty of general practitioners to relay poor prognostic features of the disease or shrinking survival rates.

Palliative Care can be of great assistance in this setting by providing holistic care, active listening to fears, anxiety, and concerns of the patient and family members alike, improve perceptions of quality of life, and assist in end-of-life preparation. Palliative care’s role in symptom management for the end stage COPD patient is crucial in regaining modest amounts of self care, facilitate energy conservation, and maximize function.


Amy Lunsford, RN, MSN, ACNP
Palliative Care Nurse Practitioner

The Special Grief that Follows a Miscarriage

Typically, when a pregnancy is realized, the mother and father begin to dream of this new one to be added to their lives, to their family. The mind allows us to imagine what it will be like to first hold this baby, to bring this little boy or girl home from the hospital. We wonder what this little one will look like; will this child have mama’s hair, or daddy’s toes? Sometimes we even project out, dreaming about the first holiday with a baby, considering what it might be like when this child goes to school. All of this is a normal part of pregnancy.

But not every pregnancy develops normally. And not every dream becomes a reality. During my year of residency as a chaplain with Texas Health Fort Worth,I was assigned to the Women and Infants unit. With my anxiety about providing pastoral care to those who experience loss through a miscarriage, I wrote to family and friends and asked them to share with me stories, feelings, and grief associated with the loss of an infant. To my surprise I received many responses, some from family members who for years had silently been carrying this hidden grief . I soon learned that many women and men remain silent about the pain of a miscarriage. And, I learned how the pain of grief does not go away, even when it is ignored.

Through my ministry with grieving mothers and fathers, children, grandparents, and staff, I am learning the importance of recognizing the significance loss that occurs through a miscarriage. I encourage folk to mourn and to expect a variety of emotions. There may be numbness and shock initially. Seeing and holding the baby is an important option to give each person who experiences a miscarriage. For some, naming and blessing the baby are sacred rituals that help to recognize the child’s worth and spirit. In addition having a funeral or memorial service is an important option. If it is determined to have a funeral, then waiting until the mother is able to attend is important.

Rev. Denise Hill

Supervisor Candidate/Chaplain in Pastoral Care Department

Planning to Have A Baby?

Taking care of your baby doesn’t start the day they are born. It starts long before.

WHAT YOU NEED TO KNOW WHEN YOU ARE TRYING TO GET PREGNANT:

Most women don’t know they are pregnant until they miss their period. The baby is often 4-5 weeks gestation at that time and many of the vital organs are already in critical stages of development. Alcohol and other drugs (even over-the-counter remedies) can cause problems for your unborn child. It is wise to avoid alcohol and other unnecessary medications if you are trying to become pregnant. One thing that you should NOT avoid is folic acid. Folic acid is a vitamin that plays an important role in the development of baby’s brain and spinal cord. Deficiencies in folic acid are known to cause neural tube defects (also known as spina bifida). Spina bifida is a birth defect in which the backbone and spinal canal do not close before birth. The spinal cord is exposed at birth and these children do not have normal function of their bladder, bowels, or legs. Many are confined to wheelchairs. This birth defect is largely preventable by taking 400mcg of folic acid per day. All women of child-bearing age are encouraged to take 400mcg of folic acid daily, either as part of a multivitamin or by eating cereals or grains with added folic acid.

I’M PREGNANT-WHAT NOW?

Once you find out you are pregnant, you need contact your obstetrician to start prenatal care. Prenatal care is EXTREMELY important for the health of you and your baby. Your doctor will prescribe prenatal vitamins to be taken throughout your pregnancy, and will send screening tests for infections that may compromise the health of your baby if untreated. In addition, your doctor will perform at least one complete ultrasound of your baby to screen for birth defects or problems with the baby’s growth. All expectant moms are screened routinely for the development of diabetes and the development of high blood pressure during pregnancy. Both of these disorders are often asymptomatic and can be very dangerous for the health of mom and baby if untreated. Last, your obstetrician can help you to prepare for the birth of your baby. They will have recommendations about prenatal classes, can discuss options for pain control during labor, and can give you important information about the benefits of breastfeeding your baby. Prenatal Care is the most important gift you can give your unborn child.

Fran Lynch, MD FAAP

Neonatatologist